in countries where the risk of such diseases is assessed to be very
high as compared to the United States. These infectious diseases
represent risks to US government personnel traveling to the
specified country for a period of less than three years. The degree
of risk is assessed by considering the foreign nature of these
infectious diseases, their severity, and the probability of being
affected by the diseases present. The diseases listed do not
necessarily represent the total disease burden experienced by the
local population.
The risk to an individual traveler varies considerably by the
specific location, visit duration, type of activities, type of
accommodations, time of year, and other factors. Consultation with a
travel medicine physician is needed to evaluate individual risk and
recommend appropriate preventive measures such as vaccines.
Diseases are organized into the following six exposure categories
shown in italics and listed in typical descending order of risk.
Note: The sequence of exposure categories listed in individual
country entries may vary according to local conditions.
food or waterborne diseases acquired through eating or drinking on
the local economy:
Hepatitis A - viral disease that interferes with the functioning of
the liver; spread through consumption of food or water contaminated
with fecal matter, principally in areas of poor sanitation; victims
exhibit fever, jaundice, and diarrhea; 15% of victims will
experience prolonged symptoms over 6-9 months; vaccine available.
Hepatitis E - water-borne viral disease that interferes with the
functioning of the liver; most commonly spread through fecal
contamination of drinking water; victims exhibit jaundice, fatigue,
abdominal pain, and dark colored urine.
Typhoid fever - bacterial disease spread through contact with food
or water contaminated by fecal matter or sewage; victims exhibit
sustained high fevers; left untreated, mortality rates can reach 20%.
vectorborne diseases acquired through the bite of an infected
arthropod:
Malaria - caused by single-cell parasitic protozoa Plasmodium;
transmitted to humans via the bite of the female Anopheles mosquito;
parasites multiply in the liver attacking red blood cells resulting
in cycles of fever, chills, and sweats accompanied by anemia; death
due to damage to vital organs and interruption of blood supply to
the brain; endemic in 100, mostly tropical, countries with 90% of
cases and the majority of 1.5-2.5 million estimated annual deaths
occurring in sub-Saharan Africa.
Dengue fever - mosquito-borne (Aedes aegypti) viral disease
associated with urban environments; manifests as sudden onset of
fever and severe headache; occasionally produces shock and
hemorrhage leading to death in 5% of cases.
Yellow fever - mosquito-borne viral disease; severity ranges from
influenza-like symptoms to severe hepatitis and hemorrhagic fever;
occurs only in tropical South America and sub-Saharan Africa, where
most cases are reported; fatality rate is less than 20%.
Japanese Encephalitis - mosquito-borne (Culex tritaeniorhynchus)
viral disease associated with rural areas in Asia; acute
encephalitis can progress to paralysis, coma, and death; fatality
rates 30%.
African Trypanosomiasis - caused by the parasitic protozoa
Trypanosoma; transmitted to humans via the bite of bloodsucking
Tsetse flies; infection leads to malaise and irregular fevers and,
in advanced cases when the parasites invade the central nervous
system, coma and death; endemic in 36 countries of sub-Saharan
Africa; cattle and wild animals act as reservoir hosts for the
parasites.
Cutaneous Leishmaniasis - caused by the parasitic protozoa
leishmania; transmitted to humans via the bite of sandflies; results
in skin lesions that may become chronic; endemic in 88 countries;
90% of cases occur in Iran, Afghanistan, Syria, Saudi Arabia,
Brazil, and Peru; wild and domesticated animals as well as humans
can act as reservoirs of infection.
Plague - bacterial disease transmitted by fleas normally associated
with rats; person-to-person airborne transmission also possible;
recent plague epidemics occurred in areas of Asia, Africa, and South
America associated with rural areas or small towns and villages;
manifests as fever, headache, and painfully swollen lymph nodes;
disease progresses rapidly and without antibiotic treatment leads to
pneumonic form with a death rate in excess of 50%.
Crimean-Congo hemorrhagic fever - tick-borne viral disease;
infection may also result from exposure to infected animal blood or
tissue; geographic distribution includes Africa, Asia, the Middle
East, and Eastern Europe; sudden onset of fever, headache, and
muscle aches followed by hemorrhaging in the bowels, urine, nose,
and gums; mortality rate is approximately 30%.
Rift Valley fever - viral disease affecting domesticated animals and
humans; transmission is by mosquito and other biting insects;
infection may also occur through handling of infected meat or
contact with blood; geographic distribution includes eastern and
southern Africa where cattle and sheep are raised; symptoms are
generally mild with fever and some liver abnormalities, but the
disease may progress to hemorrhagic fever, encephalitis, or ocular
disease; fatality rates are low at about 1% of cases.
Chikungunya - mosquito-borne (Aedes aegypti) viral disease
associated with urban environments, similar to Dengue Fever;
characterized by sudden onset of fever, rash, and severe joint pain
usually lasting 3-7 days, some cases result in persistent arthritis.
water contact diseases acquired through swimming or wading in
freshwater lakes, streams, and rivers:
Leptospirosis - bacterial disease that affects animals and humans;
infection occurs through contact with water, food, or soil
contaminated by animal urine; symptoms include high fever, severe
headache, vomiting, jaundice, and diarrhea; untreated, the disease
can result in kidney damage, liver failure, meningitis, or
respiratory distress; fatality rates are low but left untreated
recovery can take months.
Schistosomiasis - caused by parasitic trematode flatworm
Schistosoma; fresh water snails act as intermediate host and release
larval form of parasite that penetrates the skin of people exposed
to contaminated water; worms mature and reproduce in the blood
vessels, liver, kidneys, and intestines releasing eggs, which become
trapped in tissues triggering an immune response; may manifest as
either urinary or intestinal disease resulting in decreased work or
learning capacity; mortality, while generally low, may occur in
advanced cases usually due to bladder cancer; endemic in 74
developing countries with 80% of infected people living in
sub-Saharan Africa; humans act as the reservoir for this parasite.
aerosolized dust or soil contact disease acquired through inhalation
of aerosols contaminated with rodent urine:
Lassa fever - viral disease carried by rats of the genus Mastomys;
endemic in portions of West Africa; infection occurs through direct
contact with or consumption of food contaminated by rodent urine or
fecal matter containing virus particles; fatality rate can reach 50%
in epidemic outbreaks.
respiratory disease acquired through close contact with an
infectious person:
Meningococcal meningitis - bacterial disease causing an inflammation
of the lining of the brain and spinal cord; one of the most
important bacterial pathogens is Neisseria meningitidis because of
its potential to cause epidemics; symptoms include stiff neck, high
fever, headaches, and vomiting; bacteria are transmitted from person
to person by respiratory droplets and facilitated by close and
prolonged contact resulting from crowded living conditions, often
with a seasonal distribution; death occurs in 5-15% of cases,
typically within 24-48 hours of onset of symptoms; highest burden of
meningococcal disease occurs in the hyperendemic region of
sub-Saharan Africa known as the "Meningitis Belt" which stretches
from Senegal east to Ethiopia.
animal contact disease acquired through direct contact with local
animals:
Rabies - viral disease of mammals usually transmitted through the
bite of an infected animal, most commonly dogs; virus affects the
central nervous system causing brain alteration and death; symptoms
initially are non-specific fever and headache progressing to
neurological symptoms; death occurs within days of the onset of
symptoms.
Rank country Major infectious diseases Date of Information
======================================================================
Rank code: 2194
Country Comparison :: Refugees and internally displaced persons
This entry includes those persons residing in a country as refugees
or internally displaced persons (IDPs). The definition of a refugee
according to a United Nations Convention is "a person who is outside
his/her country of nationality or habitual residence; has a
well-founded fear of persecution because of his/her race, religion,
nationality, membership in a particular social group or political
opinion; and is unable or unwilling to avail himself/herself of the
protection of that country, or to return there, for fear of
persecution." The UN established the Office of the UN High
Commissioner for Refugees (UNHCR) in 1950 to handle refugee matters
worldwide. The UN Relief and Works Agency for Palestine Refugees in
the Near East (UNRWA) has a different operational definition for a
Palestinian refugee: "a person whose normal place of residence was
Palestine during the period 1 June 1946 to 15 May 1948 and who lost
both home and means of livelihood as a result of the 1948 conflict."
However, UNHCR also assists some 400,000 Palestinian refugees not
covered under the UNRWA definition. The term "internally displaced
person" is not specifically covered in the UN Convention; it is used
to describe people who have fled their homes for reasons similar to
refugees, but who remain within their own national territory and are
subject to the laws of that state.
Rank country Refugees and internally displaced personsDate of
Information
1 Iraq 2,400,000.00 2007
2 Jordan 1,835,704.00 2007
3 Congo, Democratic Republic of the 1,400,000.00 2007
4 Uganda 1,270,000.00 2007
5 Somalia 1,100,000.00 2007
6 Pakistan 1,043,984.00 2007
7 Gaza Strip 1,017,000.00 2007
8 Iran 914,268.00 2007
9 West Bank 722,000.00 2007
10 Cote d'Ivoire 709,000.00 2007
11 Zimbabwe 569,685.00 2007
12 Syria 522,100.00 2007
13 Burma 503,000.00 2007
14 Jordan 500,000.00 2007
15 Sri Lanka 460,000.00 2007
16 Lebanon 405,425.00 2007
17 Tanzania 352,640.00 2007
18 Syria 305,000.00 2007
19 China 300,897.00 2007
20 Philippines 300,000.00 2007
21 Saudi Arabia 240,015.00 2007
22 Chad 234,000.00 2007
23 Uganda 215,700.00 2007
24 Cyprus 210,000.00 2007
25 Serbia 206,000.00 2007
26 Ethiopia 200,000.00 2007
27 Lebanon 200,000.00 2007
28 Central African Republic 197,000.00 2007
29 Chad 178,918.00 2007
30 Kenya 173,702.00 2007
31 Jordan 160,000.00 2007
32 Sudan 157,220.00 2007
33 Congo, Democratic Republic of the 132,295.00 2007
34 Thailand 132,241.00 2007
35 Bosnia and Herzegovina 131,600.00 2007
36 Tanzania 127,973.00 2007
37 Armenia 113,295.00 2007
38 Nepal 107,803.00 2007
39 Burundi 100,000.00 2007
40 Timor-Leste 100,000.00 2007
41 Yemen 91,587.00 2007
42 Algeria 90,000.00 2007
43 China 90,000.00 2007
44 India 77,200.00 2007
45 Kenya 73,004.00 2007
46 Serbia 71,111.00 2007
47 Egypt 70,198.00 2007
48 India 69,609.00 2007
49 Ethiopia 66,980.00 2007
50 Bangladesh 65,000.00 2007
51 Angola 61,700.00 2007
52 Zambia 60,874.00 2007
53 Chad 54,200.00 2007
54 Iran 54,024.00 2007
55 Congo, Republic of the 48,000.00 2007
56 Congo, Republic of the 46,341.00 2007
57 Rwanda 46,272.00 2007
58 Zambia 42,565.00 2007
59 Uzbekistan 39,202.00 2007
60 Congo, Democratic Republic of the 37,313.00 2007
61 Ghana 35,653.00 2007
62 Pakistan 34,000.00 2007
63 Eritrea 32,000.00 2007
64 Uganda 28,880.00 2007
65 Serbia 27,414.00 2007
66 Sierra Leone 27,311.00 2007
67 Bangladesh 26,268.00 2007
68 Cote d'Ivoire 25,615.00 2007
69 Sudan 25,023.00 2007
70 Uganda 24,900.00 2007
71 Cameroon 24,000.00 2007
72 Senegal 22,400.00 2007
73 Guinea 21,856.00 2007
74 Malaysia 21,544.00 2007
75 Kosovo 21,000.00 2007
76 Nepal 20,153.00 2007
77 Senegal 19,630.00 2007
78 Guinea 19,000.00 2007
79 Congo, Democratic Republic of the 17,777.00 2007
80 Lebanon 17,000.00 2007
81 Iraq 16,832.00 2007
82 Ethiopia 16,576.00 2007
83 Kenya 16,428.00 2007
84 Montenegro 16,192.00 2007
85 Malaysia 15,174.00 2007
86 Congo, Democratic Republic of the 13,904.00 2007
87 Ethiopia 13,078.00 2007
88 Liberia 13,000.00 2007
89 Angola 12,615.00 2007
90 Liberia 12,600.00 2007
91 Egypt 12,157.00 2007
92 Iraq 11,773.00 2007
93 Ecuador 11,526.00 2007
94 Turkmenistan 11,173.00 2007
95 Sudan 11,009.00 2007
96 South Africa 10,772.00 2007
97 United States 10,586.00 2006
98 Papua New Guinea 10,177.00 2007
99 Burundi 9,849.00 2007
100 India 9,472.00 2007
101 Benin 9,444.00 2007
102 Djibouti 8,642.00 2007
103 United States 8,549.00 2006
104 Ghana 8,517.00 2007
105 Armenia 8,400.00 2007
106 Libya 8,000.00 2007
107 Central African Republic 7,900.00 2007
108 Sudan 7,895.00 2007
109 South Africa 7,818.00 2007
110 Guinea-Bissau 7,454.00 2007
111 Bosnia and Herzegovina 7,269.00 2007
112 Gabon 7,178.00 2007
113 Montenegro 7,000.00 2007
114 United States 6,666.00 2006
115 Congo, Republic of the 6,564.00 2007
116 United States 6,479.00 2006
117 Mali 6,300.00 2007
118 Congo, Democratic Republic of the 6,181.00 2007
119 Gambia, The 5,955.00 2007
120 Nigeria 5,778.00 2007
121 South Africa 5,759.00 2007
122 Solomon Islands 5,400.00 2007
123 Guinea 5,259.00 2007
124 Congo, Democratic Republic of the 5,243.00 2007
125 Sudan 5,023.00 2007
126 Togo 5,000.00 2007
127 Namibia 4,700.00 2007
128 Rwanda 4,400.00 2007
129 Zambia 4,100.00 2007
130 Guinea 3,900.00 2007
131 Central African Republic 3,700.00 2007
132 Kazakhstan 3,700.00 2007
133 Uzbekistan 3,400.00 2007
134 United States 3,100.00 2006
135 Cameroon 3,000.00 2007
136 Zimbabwe 2,500.00 2007
137 Azerbaijan 2,400.00 2007
138 United States 2,136.00 2006
139 Togo 1,500.00 2007
140 Georgia 1,100.00 2007
141 Uzbekistan 1,060.00 2007
142 Kazakhstan 508.00 2007
======================================================================
Rank code: 2195
Country Comparison :: GDP (official exchange rate)
This entry gives the gross domestic product (GDP) or value of all
final goods and services produced within a nation in a given year. A
nation's GDP at official exchange rates (OER) is the
home-currency-denominated annual GDP figure divided by the bilateral
average US exchange rate with that country in that year. The measure
is simple to compute and gives a precise measure of the value of
output. Many economists prefer this measure when gauging the
economic power an economy maintains vis-a-vis its neighbors, judging
that an exchange rate captures the purchasing power a nation enjoys
in the international marketplace. Official exchange rates, however,
can be artificially fixed and/or subject to manipulation - resulting
in claims of the country having an under- or over-valued currency -
and are not necessarily the equivalent of a market-determined
exchange rate. Moreover, even if the official exchange rate is
market-determined, market exchange rates are frequently established
by a relatively small set of goods and services (the ones the
country trades) and may not capture the value of the larger set of
goods the country produces. Furthermore, OER-converted GDP is not
well suited to comparing domestic GDP over time, since
appreciation/depreciation from one year to the next will make the
OER GDP value rise/fall regardless of whether
home-currency-denominated GDP changed.
Rank country GDP (official exchange rate) Date of Information